Individual provider Active NPI

Marcie Michelle Vaske

  • Nutrition Education Nutritionist
  • Chanhassen, MN
National Provider Identifier
1912388067
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
N220 Issued in MN
Practice address
2392 Harvest Way
Chanhassen, MN 55317-8444
Phone
(612) 419-9626
NPI assigned
Jun 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X N220 MN Primary

Addresses

Primary practice location

2392 Harvest Way
Chanhassen, MN 55317-8444

Mailing address

6625 Lyndale Ave S Ste 500
Richfield, MN 55423-2691
Phone (612) 419-9626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N220MNMDNutrition Education Nutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Oswald Digestive Clinic LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1912388067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 500",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232691",
            "telephone_number": "612-419-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2392 HARVEST WAY",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553178444",
            "telephone_number": "612-419-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASKE",
        "first_name": "MARCIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "MN",
            "license": "N220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanhassen, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.